Addressing Oral Health Workforce Training in the Pacific

Addressing Oral Health Workforce Training in the Pacific Dr Rodel G Nodora Technical Officer, HRH/POLHN WHO/WPRO Western Pacific Regional Office

Health Workers Save Lives The number of health professionals world-wide, and the quality and relevance of their education, is insufficient education to meet the current and future health needs of local populations. … a critical shortage was found in 57 countries. Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

HRH Action Framework WHO/WPRO adapted from: Human Resources for Health Technical Framework: achieving a sustainable health workforce World Health Report 2006 Country specific context Including labour market Critical Success Factors HRH Vision 2020 Population with access to adequate, competent, productive and supported health workforce Results-focused planning and practices System-linked alignment Knowledge-based decision-making Learning-oriented perspectives Innovative solutions Comprehensive and integrated approaches Policy Leadership Human Finance Resources for Health Systems Partnership Education Implementation Situation Analysis Preparation & Planning Improved Health Workforce Outcomes Monitoring & Evaluation Governance Health Care Financing Health Information Service Delivery BETTER HEALTH SERVICES BETTER HEALTH OUTCOMES Equity Effectiveness Efficiency Accessibility Responsiveness Critical Success Factors Country-led initiatives Government-supported actions Multi-sector engagement Multi-stakeholder involvement Donor alignment Gender sensitivity Medical Products and Technologies Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Human Resources for Health (HRH) priority issues in the Pacific ● HRH policies, planning and systems – Management of HW performance ● Multisectoral engagement, financial constraints – Status of other health system components ● Mobility of HWs (internal, international) ● Access to education and training to address: – Specific shortages; CPD requirements and how we “develop capacity” l Recruitment, retention and an ageing workforce ● Health service needs of small populations dispersed through remote, rural and outer island settings – Equity of distribution Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Pacific Health Workforce Density (Doctors, Nurses and Midwives per 1, 000 population) 2. 3 / 1, 000 (indicative minimum threshold; WHO) Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Transformative scale up of health professional education Source: Lancet 2010; 376: 1923 -58 Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

WHO’s Response to Oral Health l Oral diseases qualify as major public health problems – high prevalence and incidence in all regions of the world – the greatest burden of oral diseases is on the disadvantaged and socially marginalized populations. l Traditional treatment of oral diseases is extremely costly in several countries and not feasible or possible to most low-income and middle-income countries. l The WHO Global Strategy for prevention and control of noncommunicable diseases and the common risk factor approach is a strategy that is clearly linked to managing prevention and control of oral diseases. Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Numbers/Quantity Challenge Number of Dentists in WPRO Range: 1 in NRU and 149, 000 in AUS Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Number of Dentists in PICs Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Number of Dentists in PICs WPRO PICs American Samoa Cook Islands Fiji Kiribati Marshall Islands Federated States of Micronesia Nauru New Caledonia Niue Palau Papua New Guinea Samoa Solomon Islands Tonga Tuvalu Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Number of Dentists No. / 10 000 13 4 171 18 11 3 NA 4 2 2 2013 2009 2008 14 1 89 2 5 46 17 52 11 2 4 2 NA NA 3 1 NA 2 2008 2009 1995 2008 2007 2008 2009 2008 Year Western Pacific Regional Office

Quality (of oral health) workforce l Provide important and valuable services l Have specialist technical skills and/or knowledge l Require significant education and training l Often needs to work ‘face-to-face’ with patients l Can seldom be replaced with technology And: l Generally, a large single cost in any health system Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Approach for the Oral HWF Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Dental Assistant Career Diploma through Western Pacific Regional Office

Background l Intention of American Samoa’s oral health staff for dental assistants to be certified l Discussion with POLHN in early 2013 with Dr Stanley Gurr and Dr Talifa Jr. l POLHN Secretariat liaised with Penn Foster l WHO/POLHN covered the cost of tuition. Holds regular teleconferences with dental assistant learners and supervisors to monitor learner progress. l Face-to-face skills validation with PBDA and formal presentation of certificates. Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Structure l The diploma is self-paced and is expected to take 5 – 9 months to complete. l Penn Foster sends learning aids and course content to learners, additional resources are available online and exams are completed online. l POLHN included a face-to-face skills validation for program participants l Graduation ceremony for successful dental assistants Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

External Assessment l In collaboration with the Pacific Basin Dental Association (PBDA), an external assessor was engaged – Dr Dustin Bantol from Marshall Islands l Practical examination and skills demonstration l To reinforce the learning of the dental assistants and to contextualize things into Pacific realities l An opportunity for the dental assistants to showcase their competencies on quality customer service and communication Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Accreditation is primarily a country specific consideration. Penn Foster has received accreditation in America as follows: • State level: Penn Foster Career School is accredited for nondegree granting postsecondary programs by the Commission on Secondary Schools of the Middle States Association. • National: Penn Foster Career School is accredited by the Accrediting Commission of the Distance Education and Training Council (DTEC). • International: Penn Foster Career School has been approved as an Authorized Provider by the International Association for Continuing Education and Training. Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

POLHN The Pacific Open Learning Health Net (POLHN) is a partnership between Pacific Ministries of Health and WHO. POLHN’s goals are: 1. Improve health professionals’ access to continuing professional development (CPD). 2. Provide CPD for Pacific health professionals. 3. Build capacity among local and regional academic institutions to develop and deliver online CPD. Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Aims of POLHN nd illed a Up-sk t peten com People Processes d co an ted ers a otiv work M th l hea t den nfi Technologically literate Products Partners Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia to nowledge s the k eed ped with Equip g health n ngin nd to cha respo Western Pacific Regional Office

Way Forward l Design POLHN recommended courses per cadre guided by Career-Roles continuum l Develop more flexible courses that is practical and relevant to the contexts – Examples: • certification of dental assistants • Post graduate NCD course l Advocate for accreditation from various health professional councils in the Pacific Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Career Roles Continuum C Te ch nic al/ Cli n A R E E R les o e. R v ati r ica l. R ole ist n mi s d /A t en m e g na a Te M ch nic a l/C lin ica l. R Dental Assistants Dental Hygienists Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Dental Therapists ole s Dentists Western Pacific Regional Office

POLHN and training modes Formal Face to face learning in an education institution Ad-hoc Training and Workshops Non. Accredited Flexible learning recognized by a learning institution On the job training; coaching, mentoring Informal Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Example: CPD for Dental Cadre Dentists and Therapists Dental Technicians Management and Administration Courses Technical Courses Supervisory Courses Technical Courses Dental Hygienist and Assistants General Courses Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Technical Courses Western Pacific Regional Office

Example of Technical Course Skills Dental Assistants Dentist Radiology Oral Surgery Anatomy Paediatrics Mixing Compounds Periodontology Orthodontics Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

General Courses for Oral Health Cadre Dental Assistants/Hygienists - Infection Prevention - Patient safety - Improving personal productivity Dental Therapists - Team building and team communication - Supervision - Coaching and counselling Dentists - Strategic planning and policy development - Resource management - Leadership Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

This can be replicated in other cadres of the health sector. Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Learning Opportunities in WHO Formal Global Health Learning Center Fellowship Program Non. Accredited Pacific Open Learning Health Net POLHN Health Leadership Development Initiative (HLDI) Internship and Volunteers program Informal Addressing Oral Health Workforce Training in the Pacific 11 -13 March 2014, Pohnpei, Federated States of Micronesia Western Pacific Regional Office

Sulang! Kalangan Komol tata! Fa’afetai lava! Thank You! Western Pacific Regional Office